For someone who spends the bulk of her days working with a very small cadre of colleagues – helping very small people get well – Dr. Katrina Leshanski has big hopes.
Leshanski, a Navy veteran and mother, is one of only three pediatric hospitalists currently contracted to the Indian River Medical Center from Nemours, the world-renowned children’s hospital system with centers in Wilmington, Delaware, as well as Jacksonville, Pensacola and Orlando.
Like all pediatric hospitalists, Leshanski and her two colleagues, who are employed by Nemours but work at IRMC, are specially trained to care for children in a wide variety of hospital settings.
Depending on the hospital, that might include a separate pediatric ward, labor and delivery rooms, a newborn nursery, a special emergency department, a neonatal intensive care unit or a pediatric intensive care unit.
The problem is, IRMC doesn’t have a designated pediatric ward. Or a neonatal intensive care unit. Or a pediatric intensive care unit.
Children admitted to IRMC are typically interspersed within the adult patient population – which is where Leshanski’s high hopes come in.
Under repeated questioning, she admits she’d like to see an entire pediatric floor at the Vero hospital someday.
Whether that’s in the cards or not, one thing that’s clear is that treating children isn’t like treating a 65- or 75-year-old hip replacement patient. For starters, it’s unlikely a 75-year-old’s parents would be there in the room, but the parents of Leshanski’s patients usually are present.
Nonetheless, Leshanski says, “I tend to walk into a room and speak directly to the child, if they’re of an age where I can speak to them. Newborns aren’t, but if I have a kid who’s 4, 5, 6 or 7, I’ll talk to them first before I talk to their parents.”
Leshanski admits that sometimes “parents will try to interrupt and I’ll say, ‘Sorry, Mom, but Johnny is my patient. I’m going to talk to him first. As soon as I’m done with my questions, I’ll ask you.’ Most of the time, parents are OK with that.”
Most parents, she says, know their children are likely to be bewildered and confused by unfamiliar hospital surroundings, including all the unfamiliar faces around them, and if the child is in pain that adds a whole other dimension of stress.
“We need to work very much together,” Leshanski continues. “I know it can look like I’m hurting their child [drawing blood, for example], but I’m doing it to help them get better. I just constantly reassure parents that I’m doing everything I can to get [them and their child] out of here as fast as I can and that the children are the one driving the care.”
Pausing briefly, Leshanski adds, “you have to be good at handholding with kids and adults in pediatrics.”
Listening, she says, is even more important.
“Parents know their children better than anyone.” says Leshanski, “If they’re telling me something is wrong, I would not be doing my job if I didn’t listen and hear what they’re telling me.”
Now approaching her second anniversary at IRMC, Leshanski points out, “My first day here was Oct. 2, 2016. I got out of the Navy the last day of September, traveled here and started Oct. 2.”
And that decision wasn’t based on a desire for cushy hours after a demanding military career.
“There are three of us [pediatric hospitalists], total. So we do anywhere from five to seven days on at a time and we’re on for the whole time. We [also] take calls from home, so if we’re not immediately in the house, I’m available by phone 24 hours and I can get here within 10 minutes.”
That’s in no small part because babies about to be born don’t have wrist watches. They arrive when they want to arrive, not when it’s convenient and, as Leshanski points out, “we do, I would say, 98 to 99 percent of newborns here. We do all the deliveries that aren’t covered by the two private pediatricians that see patients here.”
Despite personal tragedy – her daughter drowned back in January – Leshanski remains buoyantly optimistic about the pediatric care she and her colleagues have been able to provide here.
Whether or not she eventually gets a pediatric floor at IRMC, she says, “ultimately our goal is always to provide the best care of the child.”
